The most common cause of blurred vision after extracapsular cataract extraction is known to be an opacification of the posterior lens capsule. The pathogenesis of posterior lens capsule opacification is primarily caused by residual lens epithelial cells. For the prevention of posterior capsular opacification, several kinds of anti-mitotic drugs is being actively investigated. But the antimitotic drugs are not clinically used due to toxicity towards the intraocular tissues. The objectives of this study is to evaluate the effect of mitomycin C and tirilazad mesylate(FREEDOX(TM)) respectively for inhibiting the proliferation of rabbit lens epithelial cells when it is administered in a short period. Lens epithelial cells from white rabbits were harvested andcultured for 4 passages. Mitomycin C was applied for 3 minutes with 0.025mg/ml and 0.05mg/ml in concentration respectively. The proliferation assay was performed by [(3)H]-thymidine uptake test. Significant decrease of lens epithelial cell proliferation appeared in both drugs.When Mitomycin-C was applied with 0.025mg/ml for 3 minutes, cell proliferation was reduced to 31.5% compared with control and in 0.05mg/ml concentration, to 12.5%. When tirilazad mesylate was applied 0.15mg/ml for 3 minutes, cell proliferation was reduced to 46.5% compared with control and in 1.5mg/ml concentration, to 7.5%. If futher investigation would show the effectives and safety of these drugs, these agents could be applied into the lens capsular bad at the time of surgery to prevent the posterior capsular opacification after cataract surgery.
Antimetabolites* ; Antimitotic Agents ; Capsule Opacification ; Cataract ; Cataract Extraction ; Cell Proliferation ; Epithelial Cells* ; Mesylates ; Mitomycin ; Rabbits

To summarize the epigenetics in renal cell carcinoma (RCC) and discuss the potential use of epigenetic modifiersas RCC biomarkers and treatments. Pertinent articles available on PubMed and google scholar database pertainingto kidney cancer and epigenetics were reviewed. Metastatic RCC is one of the most difficult cancers to treat.Although RCC is commonly known to be caused by VHL mutations, it is not enough to understand the completepathophysiology of RCC. Epigenetic factors can play a fundamental role in the pathogenesis of RCC. Epigeneticregulators are classified as epigenetic writers, readers, and erasers according to their role. In this review, wediscuss the potential role of epigenetic regulators as a biomarker for RCC. We also review medications thattarget epigenetic enzymes and are currently tried in RCC therapy.

BACKGROUND: Ski injuries depend on many factors which involve the skier's skill, the skiing environment, and skier's equipment. The purpose of this study was to determine the factors associated with fractures by skiing accident. SUBJECT: We evaluated 566 patients with ski injuries who visited to the emergency post located in the YongPyong Ski Resorts from Nov. 1996 to Feb. 1997. Among the patients,379 patients had no fracture(group I) and 187 patients had fracture(group II). RESULT: There was no differences in mean age and sex ratio between two groups. Fractures of the lower extremities were more common than the upper extremities. Slipping was the most common injury mechanism. arming-up was done in 40% of group I and in 17% of group II. The fracture injuries were more common in the skier with intermediate(45%) skill than the beginner(29%) and the ones with advanced skill(12%). The slope with intermediate difficulty was the most frequent site of fracture accidents. The fracture group tended to choose the slope beyond their skiing ability. CONCLUSION: Our results suggest that fracture during skiing can be prevented if skiers do warming-up prior to skiing and choose slope appropriate to their skiing skill.
Emergencies ; Health Resorts ; Humans ; Lower Extremity ; Sex Ratio ; Skiing ; Upper Extremity

Transcutaneous cardiac pacing(TCP) is a rapid, safe, noninvasive and easily utilized form of emergency cardiac pacing, with hemodynamically similar to transvenous cardiac pacing. This paper reports the result of transcutaneous pacing in a series of patients in emergency department.32 patients with bradyanhythmia were enrolled during the study period. TCP was successful in 29(91%) patients. No evidence of electrical capture was seen in two patients in asystole and a patient with ventricular escape rhythm. Mean capture threshold was 66 mA. Transvenous pacemaker was inserted in 18(56%) of the 32 patients during transcutaneous cardiac pacing. Twenty(61%) of the 32 patients survived and eventually discharged. Ten patients(31%) were died of uncorrectable underlying disease in spite of successful ECG capture and palpable pulse by TCP. In conclusion, TCP is a reliable, noninvasive method that offers the possibility to initiate pacing within seconds and can be used by any emergency medical staff. In our opinion, it should be considered as the first choice of emergency treatment of hemodynamically unstable bradyarrhythmia.
Bradycardia* ; Electrocardiography ; Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment ; Heart Arrest ; Humans ; Medical Staff ; United Nations

BACKGROUND: Organophosphate insecticides poisoning is one of the most common toxicologic emergencies in Korea. There have been few reports of organophosphate intoxication via parenteral route, although many reports on organophosphate intoxication by oral ingestion were present in the literature. This study aimed to validate the clinical characteristics of organophosphage intoxication according to the route of administration to the body. METHOD: Data were collected retrospectively by the review of the medical records from 49 patients with organophosphate intoxication. Severity of intoxication was classified by the Namba's Classification. Collected data were analysed and compared on the clinical features and laboratory findings between the patient intoxicated by inhalation or contact(parenteral group, n=23) and the other oral ingestion(enteral group, n=26). RESULTS: Severity class by clinical features was higher in enteral group than parenteral group. Severity class by serum cholinestetrase level was not positively correlated with severity class by clinical manifestations. Cholinesterase level tended to overestimate the severity of intoxication in parenteral group. Ventilator therapy and admission to intensive care unit were more frequently needed in enteral group than parenteral group in case that the severity class by clinical features was equal. CONCLUSION: In patients with organophosphate intoxication by parenteral route, serum cholinesterase level of the patient had disparity with clinical severity of intoxication. Considering this disparity, clinical severity should be considered as a more important indicator for treatment of organophosphate intoxication including atropinization, rather than serum cholinesterase level in patients intoxicated by parenteral route.
Cholinesterases* ; Classification ; Eating ; Emergencies ; Humans ; Inhalation ; Insecticides* ; Intensive Care Units ; Korea ; Medical Records ; Plasma* ; Poisoning ; Retrospective Studies ; Ventilators, Mechanical

BACKGROUND: Septic shock is characterized by an abnormal vascular tone that has been related to various factors. Myocardial depression can also occur in septic shock. Various experimental studies have indicated that the myocardial depression could be present early in the course of septic shock. This study aimed to assess hemodynamic characteristics according to outcome of septic shock in emergency department. METHOD: The study population comprised 20 patients admitted to our emergency department for septic shock. All patients with septic shock(prolonged hypotension, signs of tissue hypoperfusion, signs of sepsis, suspected source of infection, or documented bacteremia) had conventional serial hemodynamic evaluations in emergency department to identify early hemodynamic variables that predicted outcome. All patients were monitored with a pulmonary artery catheter and an arterial catheter. Hemodynamic measurements and oxygen profile were obtained. RESULTS: There were 9(53%) survivors and 8(47%) nonsurvivors. There were no significant differences in systolic pressure, pulse rate, mean pulmonary artery pressure, pulmonary capillary wedge pressure, systemic vascular resistance index, and pulmonary vascular resistance index between survivors and nonsurvivors at initial hemodynamic value. However, significant differences were found in cardiac index(4.3+/-0.5 vs. 2.74+/-0.7 L/min/m2), stroke volume index(44+/-10 vs. 23+/-5 ml/beat/m2), left ventricular stroke work index(39+/-11 vs. 15+/-6 gm m/m2), and right ventricular stroke work index(8.1+/-3.0 vs. 5.2+/-2.9 gm m/m2) between survivors and nonsurvivors at initial hemodynamic value. CONCLUSION: Survivors had better myocardial function than nonsurvivors during the early phase of septic shock. This results suggest that myocardial depression during septic shock develops in the early course of septic shock, which is associated with outcome.
Blood Pressure ; Catheters ; Depression ; Emergencies* ; Emergency Service, Hospital* ; Heart Rate ; Hemodynamics* ; Humans ; Hypotension ; Oxygen ; Prognosis* ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Sepsis ; Shock, Septic* ; Stroke ; Stroke Volume ; Survivors ; Vascular Resistance

PURPOSE: In comminuted intertrochanteric fractures, various operative options have been introduced. The purpose of this study was to determine whether there were differences in clinical and radiologic outcomes among bipolar hemiarthroplasty (BH), compression hip screw (CHS) and proximal femur nail antirotation (PFNA) in treating comminuted intertrochanteric fractures (AO/OTA classification, A2 [22, 23]) MATERIALS AND METHODS: We retrospectively evaluated total 150 patients (BH, 50; CHS, 50; PFNA, 50) who were operated due to intertrochanteric fractures from March 2010 to December 2012 and were older than 65 years at the time of surgery. We compared these three groups for radiologic and clinical outcomes at 12 months postoperatively, including Harris Hip Score, mobility (Koval stage), visual analogue scale and radiologic limb length discrepancy (shortening). RESULTS: There was no statistical significance among three groups in clinical outcomes including Harris Hip Score, mobility (Koval stage), visual analogue scale. However, there was significant differences in radiologic limb discrepancy in plain radiographs at 12 months postoperatively (radiologic shortening: BH, 2.3 mm; CHS, 5.1 mm; PFNA, 3.0 mm; P=0.000). CONCLUSION: There were no clinical differences among BH, PFNA, and CHS in this study. However, notable limb length shortening could be originated during fracture healing in osteosynthesis, compared to arthroplasty (BH Arthroplasty ; Classification ; Extremities ; Femur* ; Fracture Healing ; Hemiarthroplasty* ; Hip Fractures* ; Hip* ; Humans ; Retrospective Studies

BACKGROUND: Current guidelines of advanced trauma life support recommend open thoracotomy when pericardiocentesis reveals bloody pericardial effusion in patients with blunt chest trauma. However, open thoracotomy may not be always required for treating patients alive until arriving emergency department, because rapid accumulation of the blood into pericardial space results in immediate death at scene. We report our experiences of treating traumatic pericardial effusion, and discuss the therapeutic modality in patients with traumatic pericardial effusion. METHODS: The study consisted of 37 patients(20 males and 17 females with the mean age 42) sustaining traumatic pericardial effusion. The patients were divided according to treatment modality into 3 groups(group I : patients receiving conservative management, group II : patients treated with pericardiocentesis, group III : patients required emergency thoracotomy). We compared clinical presentations, hemodynamic profiles and echocardiographic findings among three groups. RESULTS: Cardiac tamponade was present in 14 of 37 patients. Pericardiocentesis was performed in 13 patients, and open thoracotomy in 4 patients. Pericardiocentesis was curative in 9 patients. Thoracotomy was performed in only 3(24%) of 13 patients required pericardiocentesis. 3(75%) of 4 patients having moderate or severe pericardial effusion from penetrating injury were required open thoracotomy. CONCLUSION: In selected patients who have traumatic pericardial effusion by blunt chest injury, pericardiocentesis may be curative, and thoracotomy may not be inquired as long as bleeding via indwelling pericardial catheter is not sustained after pericardiocentesis.
Advanced Trauma Life Support Care ; Cardiac Tamponade ; Catheters ; Echocardiography ; Emergencies ; Emergency Service, Hospital ; Female ; Hemodynamics ; Hemorrhage ; Humans ; Male ; Pericardial Effusion* ; Pericardiocentesis ; Thoracic Injuries ; Thoracotomy ; Thorax

PURPOSE: Although it is well recognized that SCLC is a chemo and radiosensitive tumor, only fraction of treated patients have a complete remission, fewer still have durable remissions. This study was performed to evaluate the clinical effects of IEP chemotherapy in patients with SCLC. MATERIALS AND METHODS: Patients with histologically proven SCLC who has measurable disease and previously untreated, were eligible. Treatment consisted of ifosfamide 1000 mg/m2 iv infusion for 1 hour on days 1~5 with mesna uroprotection; epirubicin 60 mg/m2 iv on day 1; and cisplatin 20 mg/m2 iv infusion on days 1~5 with hydration; repeated treatment every 4 weeks RESULTS: Twenty four patients(20 males, 4 females) were eligible for response to IEP chemotherapy. The two patients were excluded because one died before evaluating response to chemotherapy and the other had brain metastasis. The median age was 61(range 34-74). Fifteen patients had a limited disease(LD), nine patients had a extensive disease(ED). The overall response rate was 86.4%(CR 36.4%, PR 50%). In LD, response rate was 86.7%(CR 46.7%) and in ED, response rate was 85.7%(CR 14.3%). The median overall survival time was 43.5 weeks. The median survival time of LD and ED was 46.5 weeks and 43.5 weeks respectively. The median time to progression was 20 weeks in responders. The toxicity was moderate. One toxic death was observed. Grade 1 or 2 non-hematologic toxicities consisted of alopecia, nausea and vomiting in all cases, peripheral neuropathy in 3, hematuria in 2, mucositis in 11, and fever/infection in 6. Hematologic toxic effects included leukopenia(> or =grade.3, 16.5%), anemia(> or =grade 3, 1%), and thrombocytopenia(> or =grade 3, 6.8%). CONCLUSIONS: These results suggest that IEP chemotherapy may be useful as a treatment strategy in small cell lung cancer, but its efficacy is equivalent. The phase III study should be needed.
Alopecia ; Brain ; Cisplatin ; Drug Therapy ; Epirubicin* ; Hematuria ; Humans ; Ifosfamide* ; Male ; Mesna ; Mucositis ; Nausea ; Neoplasm Metastasis ; Peripheral Nervous System Diseases ; Small Cell Lung Carcinoma* ; Vomiting

PURPOSE: To compare the radiographic and clinical results of medial open wedge high tibial osteotomy (OWHTO) using autogenous bone graft and allogenous cancellous bone graft for medial compartment osteoarthritis of the knee with two-year follow-up. MATERIALS AND METHODS: Fifty-one patients (52 knees) who underwent medial OWHTO from October 2007 to April. 2010 were included in the study. The patients were divided into group I (n=29) that received an autogenous tricortical bone graft and group II (n=23) that received an allogenous cancellous bone chip graft. The radiographic parameters (preoperative anatomical and mechanical femorotibial angles, modified tibial bone varus angle, and posterior tibial slope), clinical parameters, bone union period, and complications were evaluated from medical records. RESULTS: The radiographic and clinical outcomes did not show significant difference between two groups. The average bone union period was 11.7 weeks in group I and 12.1 weeks in group II. The visual analog scale score on the first postoperative day was significantly higher in group I than group II. CONCLUSIONS: Medial OWHTO using allogenous cancellous bone graft for medial compartment osteoarthritis of the knee can be considered as an alternative treatment method that provides equivalent radiographic and clinical results of OWHTO using autogenous bone graft and causes less immediate postoperative pain.
Follow-Up Studies ; Humans ; Knee ; Osteoarthritis ; Osteotomy ; Pain, Postoperative ; Transplants